In recent years there has been a rapid increase in the number of people who suffer from computer-related hand injuries. Known as Repetitive Stress Injuries (RSI) or Cumulative Trauma Disorders (CTD), these conditions include tendinitis, carpal tunnel syndrome, cysts and bursitis. Symptoms can range from feelings of numbness, tingling, burning and throbbing to weakness and even paralysis in the fingers, hands and arms. Afflicted people face possible surgery, extensive loss of time at work, and, in some cases, even eventual unemployment. Often the simplest of tasks, such as picking up a fork, will be excruciatingly painful for them.
A three-year study by the National Institute for Occupational Safety and Health estimated that more than 20 percent of people whose work is primarily at a computer keyboard are affected.
The idea that certain motions or positions can cause injury is known in virtually every field of sports. When playing golf or tennis, chances are the individual has had lessons to learn the "right" way to perform a stroke. The individual worked on it and learned how to avoid positions and motions which are dangerous and are known to cause painful conditions like tennis-elbow, bursitis or tendinitis. Also at one time or another, the individual had the experience of watching someone swing a tennis racquet or golf-club and thinking that the stroke just looked wrong.
Typing at a computer keyboard may not be a sport, but with RSI's becoming so prevalent, it is clear that it must be seen as an athletic activity, with many of the risks and dangers of any athletic activity. Typing may be micro-athletic, but it is athletic nonetheless. The actual motions used in typing are small and so are the muscles involved, but that just makes the muscles all the more prone to injury. A shoulder or a thigh muscle can take a great deal more use and abuse than a tiny tendon in the hand. The slightest swelling of these tendons, or in the sheaths which protect them, can lead to debilitating pain and make it virtually impossible for one to type, or do much else.
Until now there have been several solutions for sufferers of RSI's. First, inventors have been rushing to design new keyboards, some of them requiring that the user learn a totally new typing system. Although others of the new keyboards use the traditional key layout, they are expensive, and while some of them may be beneficial, this book will demonstrate that they are not necessary for safe typing.
For the already injured, there is no substitute for the counsel and care of skilled physicians, and the medical profession has developed extensive means of helping such people to manage their injuries. These include physical therapy, anti-inflammatory drugs, anesthetics, muscle relaxants, cryotherapy (cold) and thermotherapy (heat therapy).
Splints can be placed on the hands and forearms of some victims to prevent them from getting into unnatural positions while they're typing. Unfortunately, however, these are effective on only a few of the dangerous positions, and they can sometimes even be harmful because they lock the forearms and wrists into stationary positions. The hand surgeon Peter A. Nathan was quoted in CTD News, an occupational health newsletter, as having said, "The benefits of immobilization through splints and braces is an old wives' tale. Splinting can cause a weakness in forearm muscles that bend and straighten the wrist and fingers."
The constriction of natural motion can be as dangerous to the arms as the unnatural positions which the splints are intended to prevent. Splints are a temporary solution, at best, and when they're off the wearers often go back to the habits that brought them to grief in the first place.
Other remedies include the injection of cortisone to reduce swelling and, in cases of carpal tunnel syndrome, surgery to cut the ligament at the base of the wrist. Obviously, neither is without its unwanted consequences, and even after such serious treatment patients who have not learned safer ways to work at their computers will revert to old habits, with the expectable result. As the Mayo Clinic reported in its Proceedings of July, 1989, "If followed by a return to the same traumatic environment, the operation is often unsuccessful in controlling symptoms."
Still another solution is to find a new occupation, one which doesn't involve working at a computer. Although sometimes companies can offer their employees alternative jobs, obviously this is simply not a possibility for most people. It also leads to another extremely unfortunate phenomenon, namely that some people are afraid to report these problems for fear of being thought difficult or even getting fired. Here the afflicted are caught in a double bind, because by putting off treatment they only insure that their problems will grow still worse.
The oldest cure of all is, of course, rest, and sometimes doctors are compelled to advise people that they face a lifetime of pain and perhaps permanent crippling if they don't take off from work for anywhere from a few months to several years. Unfortunately, however, the economic repercussions of this prescription are usually at least as severe as trying to find a new line of work.
As extreme as these solutions are, they do not attack the problem at its origin, namely, what people are doing at their computer to hurt themselves. They are all responses to the effects of Repetitive Stress Injuries.